Physiological Effects of Endotracheal Suctioning in Neonates: A Prospective Observational Study in the Neonatal...

Endotracheal suctioning is a routinely performed but potentially distressing intervention in neonates with an artificial airway. Although necessary for secretion clearance, ETS can provoke adverse physiological responses affecting multiple systems. This study aimed to evaluate the changes in physiological variables during ETS in mechanically ventilated neonates in a neonatal intensive care unit.

A prospective observational study was conducted in the NICU of Kasturba Medical College (KMC), Manipal, over a period from August 2022 to February 2023. Neonates aged 30 to 40 weeks of gestational age, receiving invasive mechanical ventilation, were included. Physiological parameters were recorded during 270 ETS episodes in 62 neonates. Changes in oxygen saturation, heart rate, respiratory rate, and the occurrence of complications such as airway trauma, pneumothorax, and endotracheal tube block or displacement were documented.

Among the 270 suctioning events, desaturation was the most frequently observed physiological disturbance, followed by tachycardia, tachypnea, bradypnea, and bradycardia. Secondary complications included minor airway trauma , pneumothorax, and ETT blockage. Notably, ETT displacement was not observed during the study period.

Endotracheal suctioning in mechanically ventilated neonates is associated with significant alterations in physiological variables, particularly desaturation and cardiac/respiratory rate changes. While necessary for airway management, ETS should be performed only when clinically indicated, with continuous monitoring to minimize potential adverse effects.